Painful Abdominal Wall Mass Requiring Resection in the Second Trimester

A recent report describes a case of a 28-year-old female, gravida 2, para 1, who presented at seven-week gestation for routine antenatal care.

The patient reported noticing a lump in her abdomen near the umbilicus two months before becoming pregnant, which, during pregnancy, grew rapidly. Ultrasound and subsequent MRI revealed benign characteristics and no evidence of local or distant extension. She received a recommendation for expectant management during pregnancy and surgical excision after delivery. However, the continued growth and pain-directed surgical resection of mass (measuring 3.5 cm) at 25 weeks of pregnancy. 

Histopathology showed bland spindle cells in long fascicles with compressed blood vessels, perivascular edema, and focal extravasated red blood cells. Immunohistochemical stains were positive for beta-catenin, smooth muscle actin (SMA), and desmin. Thus, she received a histological diagnosis of desmoid-type fibromatosis.

The patient showed an uneventful recovery and delivered vaginally at full term a female infant with normal Apgar scores. 

A seven-month follow-up MRI after the resection showed no residual mass or recurrence. The management plan includes continuing with clinical and radiological surveillance.

 Stemmer SM, Gomes C, Cardonick EH. A Case of Painful Growing Abdominal Wall Mass during Pregnancy Requiring Resection in the Second Trimester. Case Reports in Obstetrics and Gynecology. 2024;2024. https://doi.org/10.1155/2024/5881260